Evaluation of short-term effects of drug-loaded microspheres and traditional transcatheter arterial chemoembolization in the treatment of advanced liver cancer.

BACKGROUND: Liver cancer is a malignant tumor with high morbidity and mortality. Transcatheter arterial chemoembolization (TACE) is the main method for surgically unresectable liver cancer. In recent years, drug-loaded microspheres have been gradually applied in TACE technology. There are some controversies about the therapeutic effects of drug-loaded microspheres TACE (D-TACE) and traditional TACE. AIM: To explore the short-term efficacy of D-TACE and traditional TACE in the treatment of advanced liver cancer. METHODS: The clinical data of 73 patients with advanced liver cancer admitted to the First and Sixth Medical Centers of Chinese PLA General Hospital from January 2017 to October 2019 were retrospectively analyzed. Among them, 15 patients were treated with D-TACE, and 58 patients were treated with traditional TACE. Clinical baseline characteristics, perioperative laboratory indices, postoperative adverse reactions and postoperative complications were compared between the two groups. RESULTS: There was no statistical difference between the two groups for the postoperative response: The highest postoperative body temperature of the drug-loaded microsphere group was 38.0 ± 0.9℃ and the postoperative highest body temperature of the traditional TACE group was 38.3 ± 0.7℃ (t = -1.414, P = 0.162). For the 24 h postoperative nausea and vomiting after surgery in terms of scoring and postoperative pain scores, the traditional TACE group was higher than the drug-loaded microsphere group (χ 2 = 14.33, P = 0.014; χ 2 = 32.967, P = 0.000) and the two groups had significant statistical differences. The disease control rate at 3 mo after treatment in the drug-loaded microsphere group was 60% and the disease control rate at 3 mo after treatment in the traditional TACE group was 75.9% (χ 2 = 4.091, P = 0.252). There was no statistical difference between the two groups of data. During the follow-up period, the number of interventional treatments received was once in the drug-loaded microsphere group and the traditional TACE group received an average of 1.48 treatments (χ 2 = 10.444 P = 0.005). There was a statistical difference between the two groups. CONCLUSION: Compared with traditional TACE, D-TACE may have some advantages in the treatment of advanced hepatocellular carcinoma with a large tumor load in the short term, but the long-term clinical efficacy needs additional follow-up studies. In addition, compared with the traditional group, the patients in the drug-loaded microsphere group had better subjective tolerance and could reduce the number of interventional treatments. Therefore, D-TACE is worthy of clinical promotion.

[Value of (18)F-FLT positron emission tomography/computed tomography in diagnosis and staging of diffuse large B-cell lymphoma].

The aim of this study was to evaluate the role of (18)F-FLT positron emission tomography/computed tomography (PET/CT) in diagnosis and staging of diffuse large B-cell lymphoma (DLBCL) patients and compare with CT. Thirty-six patients with DLBCL in our hospital from September 2008 to December 2009 were prospectively evaluated. All 36 patients underwent whole body and head (18)F-FLT PET/CT and CT (chest, abdomen cavity and pelvis) were studied before therapy. The maximal standardized uptake value (SUV(max)) of every single focus and the SUV(max) of aortic arch blood pool were measured and used to calculate the median T/MB value (tumor SUV(max)/mediastinal SUV(max)) of every patient. The results showed that the consistency of (18)F-FLT PET/CT and CT examinations in focus of DLBCL was 79.10%, the sensitivity, specificity, positive predictive value, negative predictive value and accurate rate of (18)F-FLT PET/CT were 96.65%, 100%, 100%, 61.11% and 96.82%, respectively, which were much higher than that of CT (85.44%, 57.14%, 96.70%, 21.05% and 83.64%). It is concluded that the (18)F-FLT PET/CT is a good means for DLBCL diagnosis and staging, which is more sensitive and specific than CT.

[Application of positron emission tomography in evaluation of Alzheimer's disease rat model].

OBJECTIVE: To discuss the value of 11C-PIB PET and 18F-FDG micro PET imaging in Alzheimer's disease (AD) rat model. METHODS: The AD rat model was established by injection of Abeta1-40 into rat's hippocampus. Learning and memory function were estimated by the Morris water maze. Amyloid deposit and neuron loss were observed by Congo red staining and HE staining respectively. 11C-PIB PET and 18F-FDG micro PET scan were performed. Meanwhile the findings of PET imaging were compared with the results of behavior test and histology. RESULTS: The uptake of 18F-FDG in hippocampus of AD rat model group was lower than that of control group (P < 0.01). The Morris water maze showed that the escape latent period of rat model group was longer than that of control group (P < 0.01). Neuron loss was found in rat model brain. Thus the result of micro-PET imaging was matched with those of the Morris water maze and HE staining. 11C-PIB was specifically bound to beta-amyloid in rat model brain, the uptake of 11C-PIB in AD rat model was higher than that of control (P < 0.05). Abeta deposit was observed in Congo red staining so that the result of 11C-PIB Micro-PET imaging was matched with that of beta-amyloid deposition. CONCLUSION: 11C-PIB Micro-PET imaging shows the plaque deposition while 18F-FDG PET imaging reflects the change of glucose metabolism in hippocampus in AD rat model. And PET scan can be used to verify the successful establishment of AD model rat model.

[Positron emission tomography imaging of cell transplantation in a rat model of Alzheimer's disease].

OBJECTIVE: To explore the value of positron emission tomography (PET) in the Alzheimer's disease (AD) rat model verification and in monitoring the therapeutic effectiveness of cell transplantation. METHODS: A beta(1-40) hippocampus injected rat model was successfully established and neural stem cells were injected into hippocampus. Results of behavior tests and histological examinations were compared between model group and graft group, and then the N-methyl-[(11)C]2-(4 methylaminophenyl)-6-hydroxybenzothiazole ((11)C-PIB) and (18)F-fluorodeoxyglucose ((18)F-FDG) imaging were performed to observe whether the result of imaging was matched with behavior test and histological examination. RESULTS: The Morris water maze showed that the latent period of the escape was significantly longer in model group than in control group (P<0.01). In histological examinations, the neuron loss and A beta deposition were found in hippocampus CA1 and dentate gyrus of rat model. (11)C-PIB imaging showed increased uptake in model rat hippocampus district (P<0.05), while (18)F-FDG imaging showed that the uptake in the injected side of hippocampus in model group was significantly lower than that in the same side in control group (P<0.001). After cell transplantation, the latent period of the escape was significantly shorter in graft group than in model group (P<0.01). Histological examinations showed that there was no obvious changes in A beta deposition; in addition, the neural stem cells differentiated and expressed neuronal nuclei-positive cells, and continuously expressed 5-bromodeoxyuridine-positive cells for six weeks. (11)C-PIB imaging and (18)F-FDG imaging showed the uptakes were not significantly different between between model group and transplantation group(P>0.05). CONCLUSION: (11)C-PIB imaging is useful in diagnosing AD and monitoring the pathological change of AD model in vivo, while (18)F-FDG imaging provides useful visual information for monitoring short-term therapeutic effectiveness of stem cell transplantation.

[Positron emission tomography with special tracers in pulmonary abnormalities].

OBJECTIVE: To assess the value of positron emission tomography (PET) with (11)C-choline (CH), (11)C-methionine (MET), (18)F-fluorothymidine (FLT), and (11)C-acetate (AC) in diagnosis of pulmonary abnormalities and the features of pulmonary abnormalities in PET. METHODS: From June 2002 to June 2007, 100 patients with pulmonary nodules or masses confirmed by CT scans received PET with special tracers. Fifty-eight patients received CH-PET, 16 patients received MET-PET, 22 patients received FLT-PET, 4 patients received AC-PET. PET data was analyzed by visual method and semiquantitative method with standard uptake value (SUV). Diagnoses were compared with pathology and follow-up survey. RESULTS: For identification of pulmonary neoplasms with CH-PET, the sensitivity, specificity and accuracy were 84.2% (32/38), 57.9% (11/19) and 75.4% (43/57). In cancer cases, SUV had no correlation with tumor size or age. For identification of pulmonary neoplasms with MET-PET, the sensitivity, specificity and accuracy were 6/7, 6/9 and 75.0% (12/16). In cancer cases, SUV had not correlation with tumor size or age. For identification of pulmonary neoplasms with FLT-PET, the sensitivity, specificity and accuracy were 85.7% (12/14), 2/8 and 63.6% (14/22). In cancer cases, SUV had not correlation with tumor size or age. In AC-PET, only 1 case of pulmonary metastasis of kidney clear cell carcinoma showed acetate avid. Two squamous cell carcinoma and 1 adenocarcinoma didn't appear abnormal in AC-PET. CONCLUSION: CH, MET, FLT, AC are valuable in diagnosing but also lead to false positive and false negative.

[Fluorine-18 fluorodeoxyglucose-positron emission tomography imaging of carcinoma of cardia or fundus of stomach].

OBJECTIVE: To investigate the value of fluorine-18 fluorodeoxyglucose (FDG)-positron emission tomography (PET) in carcinoma of cardia or fundus of stomach. METHODS: From April 1999 to April 2005, 57 patients with carcinoma of cardia or fundus of stomach were imaged with FDG-PET. FDG-PET imaging were analyzed by visual method combined with semiquantitative analysis. The results were compared with pathological findings and follow-up results. RESULTS: In 29 untreated patients, 25 T(2) to T(4) tumors were all FDG avid and 4 T(1) cases showed nothing abnormal at the primary site. In 24 patients performed curative operation 40 resected enlarged lymph nodes beyond 1 cm were diagnosed correctly by FDG-PET. FDG-PET revealed distant metastases in 5 patients and corrected them from curative surgery candidates to late stage. In 28 treated patients FDG-PET confirmed 22 cases with recurrence or metastasis. CONCLUSIONS: FDG-PET has limited value in confirming T stage in carcinoma of cardia or fundus of stomach. It showed potential in N and M staging and predicting treatment response.

[Value of carbon-11 choline positron emission tomography in patients with pulmonary abnormalities].

OBJECTIVE: To assess the value of carbon-11 choline (CH) positron emission tomography (PET) in patients with pulmonary nodules. METHODS: From September 2002 to December 2004, 39 patients with pulmonary nodules were imaged with CH-PET. CH-PET data was analyzed by visual method and semiquantitative method. When pulmonary nodules with abnormal CH uptake appeared in PET scans confirmed by visual method, their maximum and mean standard uptake value (SUVmax and SUVmean) were measured using semiquantitative method. Diagnoses were confirmed by surgery or biopsy and follow-up survey. RESULTS: Twenty-four cancerous and 3 inflammatory nodules and 1 bronchogenic cyst were detected by CH-PET and were diagnosed malignant with visual method. Three bronchial alveolar carcinoma, 2 metastatic tumor from kidney and colon, 3 fibrous nodules, 1 cryptococcosis, 1 hamartoma and 1 sclerosing hemangioma showed nothing abnormal in PET scans. For identification of pulmonary nodules with CH-PET, the sensitivity was 89% (24/29), the specificity was 60% (6/10), and the accuracy was 77% (30/39). There were differences in SUV between 8 squamous cell carcinomas and 9 adenocarcinomas (Z = -2.937, -2.887, P < 0.01). In diagnosing 70 resected enlarged lymph nodes beyond 1 cm in 17 lung cancer patients, CH-PET had the sensitivity of 86% (25/29), the specificity of 90% (37/41), and the accuracy of 89% (62/70). CH-PET confirmed 7 distant metastases in 25 lung cancer patients. In 5 cases suspected brain metastases CH-PET identified 2 cases positive correctly. CONCLUSIONS: CH-PET can confirm malignant pulmonary nodules, but still there were false positive and false negative cases. CH-PET can evaluate N stage effectively in patients with lung cancer. CH-PET can depict brain metastases accurately.

[Fluorine-18 fluorodeoxyglucose uptake in patients with benign pulmonary nodules].

OBJECTIVE: To assess the features of fluorine-18 fluorodeoxyglucose (FDG) uptake in patients with benign pulmonary nodules. METHODS: From October 1998 to July 2004, 47 patients with benign pulmonary nodules were imaged with FDG-positron emission tomography (PET). Diagnoses were confirmed by surgery. FDG-PET data was analyzed by visual method and semi-quantitive method. When pulmonary nodules with abnormal FDG intake appeared in PET scans confirmed by visual method, their maximum and mean standard uptake value (SUVmax and SUVmean) and SUV of normal lung (SUVlung) were measured using semiquantitative method. RESULTS: Twenty-one cases showed nothing abnormal in PET scans, including 17 calcification and fibrosis, 2 hamartomas and 2 sclerosing hemangiomas. 26 pulmonary nodules were detected by FDG-PET (17 active tuberculous, 6 inflammatory pseudotumors, 3 cryptococcosis). FDG uptake of these 26 nodules was higher than that of normal lung (SUVmax, SUVmean and SUVlung were 3.04 +/- 1.65, 2.48 +/- 1.35 and 0.40 +/- 0.07, respectively, P < 0.001). Correlations were not found between FDG uptake and nodule size or SUV of normal lung or age or blood glucose level in these 26 patients (P > 0.05). SUV in 9 cases (9/26, 35%) were beyond 2.5. CONCLUSIONS: Some benign pulmonary nodules were FDG avid.

[Relationship between overexpression of facilitative glucose transporter-1 and fluorodeoxyglucose uptake in primary human lung adenocarcinoma].

OBJECTIVE: To assess the relationship between the overexpression of facilitative glucose transporter-1 (Glut1) and fluorine-18 fluorodeoxyglucose (FDG) uptake in patients with primary lung adenocarcinoma. METHODS: From April 1999 to March 2001, 24 patients with lung adenocarcinoma were imaged with FDG positron emission tomography (PET) before surgery. Their maximum and mean standard uptake value (SUVmax and SUVmean) of tumor and SUV of normal lung (SUVlung) were measured. The expression of Glut1 of all 24 cases was studied in paraffin sections by SP immunohistochemistry. RESULTS: All 23 tumors tested were Glut1 positive. (35 +/- 23)% of tumor cell area was positive and staining intensity was (3.7 +/- 0.9). All tumors of the patients could be detected by FDG-PET. FDG uptake of tumor was higher than that of normal lung (P < 0.01). SUVmax, SUVmean and SUVlung were (5.46 +/- 3.32), (4.05 +/- 2.54) and (0.43 +/- 0.15) respectively. Correlations were found among Glut1 expression and FDG uptake and tumor size (P < 0.01). CONCLUSION: Glut1 overexpression is universal in the lung adenocarcinoma and correlate with FDG uptake.

[Value of fluorine-18 fluorode oxyglucose-positron emission tomography in patients with small cell lung cancer].

OBJECTIVE: To investigate the value of fluorine-18 fluorodeoxyglucose (FDG)-positron emission tomography (PET) imaging in patients with small cell lung cancer. METHODS: From February 2000 to July 2003, 17 patients with small cell lung cancer were imaged with FDG-PET. FDG-PET scans were analyzed by visual method. The FDG-PET results were compared with the pathological results and results of follow-up survey. RESULTS: 15 primary tumors were all FDG avid. By visual method 63 areas metastatic lymph nodes in 15 cases were revealed and more distant metastases outside the hemithoraxes were confirmed by FDG-PET than by routine examinations. FDG-PET corrected the diagnosis 5 cases from local disease (LD) to extended disease (ED). CONCLUSION: FDG-PET has great value in staging and treatment of patients with small cell lung cancer.

[The usefulness of FDG-PET in patients with cervical lymphadenopathy].

OBJECTIVE: To assess the usefulness of 2-(fluorine-18) fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) in patients with cervical lymphadenopathy. METHODS: From March 1999 to October 2001, 27 patients with cervical lymphadenopathy were imaged with FDG-PET. Maximum and mean standard uptake value (SUVmax and SUVmean) of lymphadenopathy and SUV of normal cervical tissue (SUVneck) were measured. All 21 patients with malignant lymphadenopathy got pathologically confirmed. RESULTS: All 26 malignant lymph nodes in 21 patients could be detected by FDG-PET. FDG uptake of these nodes was higher than that of cervical tissue (SUVmax, SUVmean and SUVneck were 4.62 +/- 2.31, 3.45 +/- 2.74 and 0.55 +/- 0.08, respectively P < 0.001). Other 9 benign lymph nodes in 6 patients couldn't be detected by FDG-PET. The accuracy of PET in 21 patients with malignant lymphadenopathy, was higher than those of routine examinations such as ultrasonography plus CT or MR (P < 0.001). CONCLUSIONS: FDG-PET allows effective diagnosis of patients with cervical lymphadenopathy and can contribute substantially to patient care.

[Preliminary research of the relationship between overexpression of facilitative glucose transporter-1 and fluorodeoxyglucose uptake in primary human lung squamous cell carcinoma].

OBJECTIVE: To assess the relationship between the overexpression of facilitative glucose transporter-1 (Glut1) and fluorine-18 fluorodeoxyglucose (FDG) uptake in patients with primary lung squamous cell carcinoma. METHODS: From April 1999 to March 2001, 23 patients with lung squamous cell carcinoma were imaged using FDG positron emission tomography (PET) before surgery. Their maximum and mean standard uptake values (SUVmax and SUVmean) of tumor and SUV of the normal lung (SUVlung) were measured. The expression of Glut1 of all the 23 cases was analysed in paraffin sections using SP immunohistochemistry. RESULTS: All the 23 tumors tested were Glut1 positive (69 +/- 18)% of tumor cell area was positive and staining intensity was 4.6 +/- 0.7. All tumors of the patients could be detected by FDG-PET. FDG uptake of tumor was higher than that of normal lung (P < 0.01). SUVmax, SUVmean and SUVlung were 8.33 +/- 4.14, 6.10 +/- 3.00 and 0.38 +/- 0.13 respectively. Correlations were found among Glut1 expression and FDG uptake and tumor size (P < 0.01). CONCLUSIONS: (1) Glut1 overexpression is universal in the lung squamous cell carcinoma. (2) SUV was higher in the lung squamous cell carcinoma than that of the normal lung tissue. (3) Glut1 expression and FDG uptake and tumor size appear to be correlated with each other in patients with lung squamous cell carcinoma.